エビデンスに基づくADHDの治療： 心理社会的療 …

1 adhd E , Jr., Center for Children and Families Copyright Since2011 William E. Pelham, Jr., Ph. D. FIU Center for Children and Families All Rights Reserved McNeil / Alza / Janssen (Concerta)AbbottShire (Adderall, Adderall XR, guanfacine)Noven (Daytrana)Lilly (Strattera)Cephalon (Sparlon) (Noven) 50 (Impairment) (1) (2) (3) (parenting)

2 / adhd ( ) (AAP, 2001; Pelham & Fabiano, 2008)(1) 1 1 (2) (3) (4) (5) (EEG) (6) (7) (8) (9) (10) (11) ( ) adhd (1) 175 (2) 300 (3) (1) (2) 25 (AAP,2001;Fabiano,Pelhametal,2009;Greenh ill&Ford,2002;Hinshawetal,2002.)

3 Pelham&Fabiano,2008)Fabiano et al, Clin Psych Review 2009 AAP Clinical Practice Guideline: Treatment of the School-Aged Child with Attention-Deficit/Hyperactivity DisorderPediatrics, 2001 adhd and/or (AAP) APA (2007) (AACAP) (2007) NICE (2009) CHADD adhd , 1993 2003 Scheffler, , Hinshaw, , Modrek, S.

4 , & Levine, P. (2007). Trends: The global market for adhd Medications. Health Affairs, 26(2), 450-457. adhd adhd adhd adhd adhd 1 (8 16 ) ( ) ( 2 3 / )

5 ( ) ( ) (Kent et al, in press; Loe & Feldman, 2007;Molina et al, 2009; Robb et al, in press) adhd 33 2 adhd 48% 1 3 adhd 12% vs. 5% adhd 9% vs. 1% adhd adolescents a full letter gradelower than controls, with twice the rate of absencesADHD (1) (2)

6 1 , and/or adhd adhd (Milich& Landau, 1982; Pelham & Bender, 1982) adhd adhd ( ) ( 9 8 ) (6 ) ( ) ( )

7 adhd ( , adhd Florida International University (Miami)Buffalo (Summit Educational Resources)New York City (NYU Medical Center)Cleveland, OH (Cleveland Clinic)Irvine, CA (UCI)Birmingham AL (UAB Medical Center)Boston (Harvard/JBCC)Chicago (Univ IL Medical Center/ & Chicago Parks) , ( )2005~ , ( ) 2010~ ( ) 2011~Erie, Johnstown, and Indiana PA (4 Community Agencies with 20 different sites)Community sites in Salt Lake City, WVA, NJ, NYC (Staten Island MH Society), WNY (Chatauqua))

8 , WASmaller, shorter camps in many cities that use parts of STP adhd 1 1 (Molina et al, 2009) (Swanson & Volkow, 2008) 1) 2) 3) 4) ( ) 6) 7) 8) 9) 10) 11) (Swanson & Volkow, 2008) (Pelham et al, 2001) adhd 1 Marcus, , Wan, , Kemner, , & Olfson, M.

9 (2005). Continuity of methylphenidate treatment for Attention Deficit/Hyperactivity Disorder. Archives of Pediatric and Adolescent Medicine, 159, 572-578. (Pelham & MTA Coop. Group, )MedmgtCombBeh / 12%4%0% 8%3%5% 8%1%2% 4%2%2% 31%15%24% 38%76%67% MTA , Concerta, Adderall XR 1 184 1 : 15-20 mg MPH; 10 mg Adderall 1-3 :5400 mg 10,800 mg MPHMTA , Concerta, Adderall XR 1 : 36 mg Concerta; 20 mg Adderall XR (1 365 ) (.)

10 , MTA): 12 :14,600 mg/year X 12 =175,000 mg MPH adhd (Fabiano et al, 2009; Greenhill & Ford, 2002) (4 15 ) 0 .74 6 adhd NIMH/USOE 4 576 3 1 5 6 1 144 1 1 24 14 10 1000+ 10+ 14 MTA 4 Beh adhd